This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Canada’s first case of coronavirus not linked to travel suggests we need to expand our surveillance systems to prevent an explosion of new cases, infectious disease experts say.
The latest case of COVID-19 in British Columbia, a woman in her 50s who has no recent travel history to affected regions worldwide or contact with infected individuals, signals a shift in the spread of the virus in Canada.
“There’s likely at least one other person out there who has this disease or had this disease, and we need to find them,” B.C. provincial health officer Dr. Bonnie Henry said Thursday.
Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital, said this means there could be more cases in the province that are likely being missed by current screening measures.
“There is some degree of transmission in B.C.,” he said. “We don’t know the size and scale of it, but it’s definitely there and the goal for surveillance systems would be to help shed light on what the degree of community transmission is.”
B.C.’s provincial health officer, Dr. Bonnie Henry, said health officials are looking for at least one other person in the community who has or had the illness. (Ben Nelms/CBC)
Bogoch said Friday that while it’s been important to have systems in place to screen for patients travelling from affected regions, the concern now is how sensitive those systems are at picking up new cases in the community.
“Clearly something is happening under the radar of the surveillance system,” he said.
“It doesn’t mean the surveillance system is bad, it just means that there might be low levels of transmission or the surveillance system has not cast a wide enough net yet.”
Currently, most health-care workers in Canada are screening only people who show up with flu-like symptoms such as fever and dry cough and say they’ve travelled to any of seven places — China, Japan, Hong Kong, Italy, Iran, Singapore and South Korea.
An ambulance transports a patient from the Life Care Center of Kirkland, the long-term care facility linked to confirmed coronavirus cases in Washington state. (David Ryder/Reuters)
“We’ve been looking for people coming into the country with it; we have not been doing widespread community screening,” said Dr. Michael Gardam, an infectious disease specialist at Humber River Hospital in Toronto.
“But, with the announcement from British Columbia, obviously that is going to continue to ramp up.”
U.S. case a concern for Canada
Given B.C.’s proximity to Washington state, provincial health officials are working closely with their U.S. counterparts.
Henry, the provincial medical officer of health, said one of the eight new cases in B.C. is a resident of Seattle who was visiting relatives in the Fraser Health region when she tested positive.
“Clearly that is of concern with us,” she said.
But part of what Henry calls the “disease detective work” to trace where the visitor may have contracted COVID-19 south of the border also depends on decoding the genetic sequence of the virus from Washington state’s “patient zero” — the initial patient.
The traditional public-health approach relies on finding cases by interviewing someone who is infected and tracing those they’ve been in close contact with. Now, scientists also use genetic fingerprinting of the virus to complement efforts to find and isolate patients quickly.
“If all community-based transmission can be traced back to a patient zero early on in an outbreak, that’s usually a good sign,” said Matthew Miller, who studies viruses and the immune responses to them at McMaster University in Hamilton, Ont.
The problem is that once the virus is spreading without a clear link to the source of the disease, tracking patient zero becomes less useful for containment purposes.
Canada isn’t there yet, Miller said, which is why community surveillance for COVID-19 takes on more importance right now. That’s why some hospitals across the country are moving toward testing all patients with flu-like symptoms.
Bogoch said expanding the list of countries to screen travellers from would be ineffective compared to community screening, because the list of places will become unmanageable.
“It’s just going to be an extreme challenge to be able to detect all the imported cases,” he said.
“At which point we’re just going to see more and more community-acquired cases in Canada.”
WATCH | WHO chief worries ‘lean and mean’ hospitals lack ability to deal with emergencies
WHO director-general Tedros Adhanom Ghebreyesus says hospitals in wealthy nations try to operate efficiently, which could mean they don’t have enough capacity to deal with emergencies such as the COVID-19 outbreak. 1:48
Dr. Jerome Leis, medical director of infection prevention and control at Toronto’s Sunnybrook Hospital, led a study in the Canadian Medical Association Journal Friday on what the early Canadian experience screening for COVID-19 shows us about how to prepare for a pandemic.
Leis said curbing community spread limits the number of infections and reduces the proportion of patients who fall critically ill.
“Hospitals throughout Ontario have stepped up the surveillance … and so we’re testing individuals that have not travelled,” Leis said. “I think we should be stepping it up further.”
In the event of a pandemic with widespread community spread, it’s “simply not feasible, nor is it safe,” to test everyone, he said.
“It will lead to overcrowding of hospitals and emergency departments,” he added. “That could just further increase the risk of exposure as people are diverted to hallways and have long wait times to be seen.”
Instead, Leis recommends building capacity both in hospitals for those who are critically ill with COVID-19 as well as in the community for the majority who have mild illness.
“Hospitals are not the best place to be assessed and tested for COVID-19,” said Leis.
“We really need to be changing the conversation from a hospital-driven model for people that are concerned about COVID-19, to one that is better supported in the community for the people who don’t need hospitalizations.”
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MONTREAL – One expert says entry-level pay under the tentative deal between Air Canada and its pilots could be a stumbling block ahead of a union vote on the agreement.
Under their current contract, pilots earn far less in their first four years at the company before enjoying a big wage increase starting in year five.
The Air Line Pilots Association had been pushing to scrap the so-called “fixed rate” provision entirely.
But according to a copy of the contract summary obtained by The Canadian Press, the proposed deal announced Sunday would merely cut the four-year period of lower pay to two years.
John Gradek, who teaches aviation management at McGill University, says as many as 2,000 of Air Canada’s roughly 5,200 active pilots may earn entry-level wages following a recent hiring surge.
After the airline averted a strike this week, Gradek says the failure to ditch the pay grade restrictions could prompt pushback from rank-and-file flight crew and jeopardize the deal, which is up for a vote next month.
This report by The Canadian Press was first published Sept. 18, 2024.
ROME (AP) — Salvatore “Totò” Schillaci, the Italy striker who was top scorer at its home World Cup in 1990, has died. He was 59.
Schillaci had been hospitalized in Palermo following treatment for colon cancer.
The Palermo Civico hospital said in a statement that Schillacci died on Wednesday morning after being admitted 11 days ago.
Schillaci scored six goals for Italy during the 1990 World Cup. He came on as a substitute during Italy’s opener against Austria, scored in a 1-0 victory, and went on to earn the Golden Boot awarded to the tournament’s top scorer. He only scored one other goal for Italy in his career.
Italian soccer federation president Gabriele Gravina announced that a minute of silence would be held in memory of Schillaci before all games in the country for the rest of the week.
“The uncontrollable celebrations, in which his face was the symbol of shared joy, will remain forever part of Italian soccer (history),” Gravina said. “Totò was a great player, a symbol of tenacious desire and redemption. … His soccer was full of passion. And that fearless spirit made everyone appreciate him and will make him immortal.”
Schillaci also won the Golden Ball award at the 1990 World Cup as the tournament’s top player ahead of Lothar Matthaus and Diego Maradona.
Schillaci played for Messina, Juventus, Inter Milan and Japanese team Jubilo Iwata during his club career.
“You made an entire nation dream during the Magical Nights of Italia ’90,” Inter said on its social media channels.
West Germany won the 1990 World Cup, beating Argentina in the final, while Italy beat England for third place with a winning penalty kick from Schillaci.
Roberto Baggio, who scored Italy’s opening goal in the third-place match, wrote on Instagram, “Ciao my dear friend.”
Having been born and raised in Palermo, the Palermo soccer team announced that it would hold a public viewing of Schillaci at its Renzo Barbera stadium ahead of the funeral, the Gazzetta dello Sport reported.
French soccer player Wissam Ben Yedder will stay free ahead of his trial on charges of sexual assault while intoxicated, one of his lawyers told The Associated Press on Wednesday.
Marie Roumiantseva said Ben Yedder will remain under strict judicial supervision after a woman filed a lawsuit for sexual assault earlier this month.
The 34-year-old Ben Yedder, a prolific striker in the French league, was briefly detained then released after the alleged incident in his car on the French Riviera. Ben Yedder had been stopped by police after he first refused to do so. He was then put in a jail cell.
After he was summoned to appear in court on Oct. 15 and placed under judicial supervision, the Nice prosecutor’s office appealed the decision not to remand the player in custody. The investigative chamber of the Court of Appeal of Aix-en-Provence did not grant this request and kept Ben Yedder under judicial supervision.
Ben Yedder attended a hearing Tuesday during which he offered to go to rehab. He has admitted he drove while under the influence of alcohol but has denied any sexual assault.
In a separate legal case last year, Ben Yedder was charged with “rape, attempted rape and sexual assault” over another alleged incident in the south of France.
Ben Yedder has been without a club since his contract with Monaco expired at the end of last season.
